摘要
目的 评价缺血修饰白蛋白（ischemia modified albumin,IMA）对以胸痛为主诉到急诊室的患者的早期诊断价值.方法 入选188例研究对象,包括142例有胸痛症状,怀疑急性冠脉综合征（ACS）的患者及46例健康志愿者.依据肌钙蛋白检测结果,患者组肌钙蛋白阳性的69例为胸痛1组,肌钙蛋白阴性的73例为胸痛2组,其中10例患者依据临床特点及心电图等检查确诊为不稳定型心绞痛.组间比较采用方差分析,并绘制ROC曲线,根据ROC曲线选定IMA的理想截断点.结果 肌钙蛋白阳性组IMA平均值明显高于肌钙蛋白阴性组[（126.44±9.73）U/mL vs（101.93±8.67）U/mL,P〈0.01],以IMA的检测值99.5 U/mL为截断点,IMA诊断ACS的敏感度为96.3%,特异度为57.1%.结论 IMA可能是急诊室早期排除胸痛患者为ACS的有用指标.
Objective To evaluate whether ischemia modified albumin （IMA） is a useful biomarker for the identification of acute coronary syndrome （ACS） in patients presenting with acute chest pain at early stage in emergency department. Methods We selected 188 subjects： 142 consecutive patients with chest pain were suspected of ACS and 46 heathy volunteers. According to the result of troponin I（ Tnl）, all the patients were classified to either the TnI positive group （n = 69） or Tropin I negative group （ n = 73 ） , among TnI negative group there were 10 patients whose final diagnosis were unstable angina pectoris. SNOVA was used to compare IMA between different groups, and receiver operating characteristicl（ROC） was obtained. The ideal cutoff value of IMA was calculated by the ROC curve analysis. Results Mean IMA levels were higher in the patients with positive TnI （ 126.44 ± 9. 73） U/mL than in the patients with negative TnI （ 101.93 ± 8.67） U/mL （P 〈 0. 01 ）. Based on IMA levels （99.5 U/mL） , IM＇A had a sensitivity of 96.3% and specificity of 57.1% for the diagnosis of ACS. Conclusion IMA may be a useful biomarker to rule out ACS in patients presenting with acute chest pain at the early stage in emergency department.
出处
《中国急救医学》
CAS
CSCD
北大核心
2011年第8期733-735,共3页
Chinese Journal of Critical Care Medicine
作者简介
李贵华（1971-），男，博士，副主任医师。
